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Contact Information

MAIN STREET MEDICAL CENTER INC
24 SOUTH MAIN STREET
SHENANDOAH, PA17976
 Phone: 570-462-1033
 Fax: 570-462-1171
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for MAIN STREET MEDICAL CENTER INC · (Female)

NPI # 1063561041
Status Active
Credentials
Entity Individual
Enumeration date 01/09/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor 1 Not specified
Identifiers
  • PA License # MD418365
  • PA Medicaid 0019487500001
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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